autoimmune diseases in people with MS and their
relatives have been studied many times. Studies have employed different
designs, and yielded conflicting results.
Objective: We performed a systematic
review, and calculated overall risk of additional autoimmune diseases in
people with MS and their first-degree relatives.
Methods: PubMed and Web of
Science were searched. Thyroid disease, diabetes, inflammatory bowel
disease, psoriasis, rheumatoid arthritis (RA) and systemic lupus
erythematosus (SLE) were studied. A generic inverse variance model was
used, and subgroup analysis was used to explore heterogeneity.
Results: The odds ratio (OR) of
thyroid disease was increased in both people with MS (OR 1.66; p <
0.00001) and their relatives (OR 2.38; p < 0.00001). A similar
association was seen between MS and inflammatory bowel disease (OR 1.56;
p < 0.0001) and psoriasis (OR 1.31; p < 0.0001), although not in
relatives. There was no increase in the rate of either SLE or RA.
Studies examining diabetes showed significant heterogeneity and evidence
of publication bias.
Conclusion: There is an increase in the rate of certain
autoimmune diseases in people with MS and their first-degree relatives.
However, this does not extend to all conditions studied. Given the
non-specific clinical presentation of thyroid disease, it should be
considered in all people with MS presenting with non-specific symptoms.
This is a study by Dr Ruth and Prof G, which indicates that MSers are more likely to also develop thryroid gland disease as well as inflammatory bowel disease and even psoriasis. Therefore it is perhaps of interest that thyroid disease occurs when the immune system regenerates after taking alemtuzumab. Therefore it is augmenting a natural tendency that is there. This suggests that there may be some common aetiological cause, but what is it?/What are they?